26 Months 13 days Post Op #2
It’s been a year since my last post and 3 years and 10 months since my initial injury and surgery. I still check in at achillesblog from time to time, but generally leave the commenting to the newer crop of rupturees. I decided to add another post because I notice the “healing long” topic comes up every few months, and I know there aren’t many resources available for reference. So, as one who “healed long”, I’m including an update to give a long range perspective now that it’s been over two years since I had a second surgery to shorten the tendon.
Life is back to “normal” in the same way it has been for the last year. The injury is still a part of my life, but it doesn’t hold me back from doing or trying the activities I enjoy. Running continues to be my main source of exercise and I completed another marathon earlier this month, my second since the injury. I finished up a few minutes faster than last year, achieving my main goal, and just a minute off my personal best. I can’t help but think that I would have cut several more minutes off my time if I wasn’t still trying to overcome this injury. Aside from a break during marathon training, I still work on strengthening my calf which continues to be the main shortfall of my recovery.
The rehab from the second surgery has lasted much longer than I ever imagined. My surgeon did warn that it could take 18 months, but of course I felt like I’d be back to normal within a year. 18 months passed and I was still concerned/disappointed with my recovery. I made some slow progress, but my calf strength was still lacking and I was dealing with some nagging tenderness in my heel.
Eventually I decided to meet with a new ortho just to seek a different opinion. I was fortunate enough to get in contact with a foot & ankle specialist who was not only familiar with achilles reconstruction as a surgeon, but also as a patient. Dr. C had chronic issues with his ATs which eventually required surgery a few years ago. He had lengthening issues in both tendons following surgery, and eventually had shortening surgeries performed on both legs. One leg even required a third surgery. My appointment with him was very surreal. I felt like we were a couple of war veterans swapping combat stories. Unfortunately, I got so caught up with talking to him as a person and fellow patient that I forgot to ask many of the medical questions I had such as, “What can cause a tendon to heal long?”.
After comparing calves and recovery stories, Dr. C described a tendon augmentation surgery that could improve my situation. However, he quickly recommended against such a surgery as he felt the potential benefits were likely to be minimal and not worth the inconvenience of another surgery. Hearing a surgeon recommend against surgery just about knocked me out of my chair, but it made his opinion that much more valuable. At that point I felt I had explored all my options, and determined that time and continued strength training were my best options for getting closer to 100%.
It’s been 6 months since I met with Dr. C and I’m happy that I continue to notice some small improvements. My right calf is still weak when compared to my left leg, but it is better than it was earlier this year and definitely better than it was prior to the second surgery. The tenderness that I constantly felt in the tendon finally dissipated within the last few months and my ankle movements feel more fluid and natural. I still struggle a bit with single leg heel raises. I can’t quite get the last bit of push to really extend up onto my toes. I’m able to do so if I cheat a little bit and use my finger tips to help with balance and offset a bit of weight, but still a bit weak. My running stride is also a little weak and I still feel I’m recruiting other muscles to offset the lack of calf strength. But, this too is better than where it was 6 months ago. I may try some different things with my stride, such as shortening it, now that I’m done marathon training for awhile. We’ll see if that makes any difference. In the end, I think it just comes down to calf strength.
So, where do I go from here? The last few months have been encouraging even though my calf is still not as strong as I’d like it to be. It’s good to know I’m still making progress given that the second surgery was over two years ago. I’m somewhat resigned to the fact that a 100% recovery is not in the cards for me, but it doesn’t mean I can’t continue to move forward. If I had to guess, I would say I’m somewhere around 75-80%. As I mentioned earlier, the missing strength doesn’t keep me from doing anything I want to do, but I’m not able to do things quite as well as before the injury. I can’t jump as high or as long, but I can still jump. My running stamina may not be as strong, but I’m still able to run long distances. So, overall I can’t complain much. The last goal I’d like to achieve is to get to a point where I don’t think about my calf or tendon when attempting to jump or hop on my right leg. Hopefully that happens soon.
Healing long seems to be a poorly documented and/or understood complication of an achilles injury. Fortunately for those concerned, I’m sure the main reason for the lack of information is the infrequency of the condition. It is something to be aware of during rehab, but hopefully not something that creates any more concern than the injury itself.